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PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />qPPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />: ITG 11DC�RESS �� <br />.�� ,��a' —/1 � � -S�`= <br />L[G�11 LOT NO.� <br />nrsc. <br />�„��R � h1C � e°�''t L <br />TENANT �lAME <br />��i LA- l l �'4� 71 f�Oc�f <br />t� <br />CONTR. LICENSE It �/ <br />��h� <br />USE OF BUILDING <br />BLOCK <br />.�i�i-la� <br />PARCEL TAX I.D. i1 <br />TRACT OR SUBDIVISION If <br />i b"!.�-�9a <br />� 68/ /3�'_. <br />FOR PERMIT <br />PERMIT p <br />�f.�LLc��7���� '1.�5NE�r`1- <br />HEATSOURCE <br />P.Icdric _ Gas _ Olher <br />— -`--- <br />WORK DESCRIPTION �����, ��.L ��(,(�f �'v+-� <br />G� <br />MBINC <br />TVPE OF FlxTURE OR ITEM <br />1 oticl <br />f3�IhIu6 <br />Lavalory (wash basm) <br />Showcr <br />Kitchen sink 8 disposal <br />Dishwashcr <br />Clothes washcr <br />Walet heater <br />Sink (servicolbarlmopletc i <br />[3ackflow prevenlcr <br />Urin�l <br />Drinking Founlain <br />Floar drain <br />Grease Irap <br />Roo( drains <br />Olher __ <br />rn...... <br />_yss _ <br />HUrvt <br />,��,C, -�/.3s 7.3$`� <br />CONTRACT PRICE OF WORK <br />� L� j <br />'..-' / �/ <br />NO. I TYPE OF fl%TURE OR 17EM <br />� <br />A/C - air handling units <br />Purced air syslems <br />Gas piping <br />Waler heater <br />Gas fireplace <br />Gas rango <br />Clolhes dryer <br />Ran�o hood <br />Cxhnust (an <br />Heal pump <br />Unit healci <br />Boiler <br />Retngeration <br />Woodslove <br />Olher <br />� I —�--- � � —._. <br />-"�-- CITY OF EVERETT LOCAL SALES TAX CODE 19 3705 <br />--�--- <br />I hereby r.ertity Ihat I havr. read and examined ihis appiic�iiun and know ihe aemc �o bc truo nnd correo�. nn pro��s+nns o� taws and <br />to grve�nulhonly tolv date orrcanc I tl U p ov s on oflan,v ol'her etat Qo local law1 regulatng con trucl on o the peetormance ol � Presume <br />construcli�n. 1 hat I am aulhorvrd by the owner o� :ms propedy to pertorm Iha work lor which applicalion is made end I comply with the <br />S�alc C itrectors I.ow 1827 (.W and 29G7�� W�C. O <br />� � �1 � �(�� d �j��� <br />� i�'^u � .-aili.�=------"r` I)� <br />SignaWie o wnerlContractorlAuthor,[ed Agent <br />